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HomeMy WebLinkAboutS2019-0052 - PermitsPERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION t City of Newport Beach - Building Division IIIIIIIIIIIIIi�lllllllllllll�lllllllllllllllllll P001 -Permit: S2019-0052 a 6 " 100 Civic Center Drive, Newport Beach, CA 92660 S. 2 0 1 9 0 0 5 2 Project No: 0656-2019 Permit Counter Phone (949)644-3288 Inspection Requests Phone (949)644-3255 Job Address: 23 SPLENDORE DR Floor. Suite: Bldg: 1 Description of Work:NEW SPA (35 SF) Inspector Area S Plan Check No: 0656.2019 Code Edit: 2016 Legal Description: TRACT 14773 LOT 6 POR. AND PORS. OF LOTS 7 AND GOF PROJECT 935-34 Owner GRUBEEBERHARD Contractor: INFINITY POOL SERVICE Architect; Address: PO BOX 20111 Address: 9121 ATLANTA AVE #638 Address: STANFORD, CA 94309 HUNTINGTON BEACH CA 92646 Phone' Phone: 714-262.9164 Phone: State Lie: Applicant: INFINITY POOL SERVICE Con State Lie: 891370 Engineer: BIEDENBACH CHRISTOPHER Address: 840 WEST 19TH. STREET : Lie Expire (0212812021. Address: 1201 N TUSTIN ' COSTA MESA,. CA 92627 Bus Lie: BT30063051 - ANAHEIM CA 92807 Phone:. 714-262-9164 Lie Exp Date:. 1 213112 01 9 Phone: 714.630.6100 State Lic:C•074003 Building _ Rear: - Worker's Compensation Insurance Special Conditions: Setbacks: Front; Carrier: STATE COMP Lp:° ° Policy No:. 9159411 Expiration: 06/20/2019 Issued Date: 05/0712Q19 . � ' `- ConstPffcYi0i4Type:. ® - ° o m FEES Censlractoon Valuation: $19,000.00 o too BEiiltr%fPermit Fet16.°° $405.00 - Record Management: $4.00 Water Quality - Permit Issuing Fee::om�° $0.00 Building Dept Inspection Fee: .$0.00 Inaestigation Fee: $0.00 Drainage Permit Fee: ':$0.00 Water Quality Dept Insp Fee: $0.00 BOiJ,dtng°Green Fee:' $1.00. Drainage Plan Check: $0.00 Building Dept WQ Plan Check: .$0.00 Plan Dept Plan Qieok:° Q $0.00 Grading Consultant Fee: $0.00 - Others -Building-Csep Plan Giieek: $361.00 $0.00 BSilding. PC Investigafien : $0.00' . Additional Fee: $0.00 $0.00 Plan check Ext.. Elea �°° —$0.00 WQ Compliance Insp Fee: $0.00 TOTAL FEE: $771.00 Plan Check Fee : $361.00 Fee Due at Permit Issuance: $410.00 PROCESSED BY: PLAN CHECKED BY:: ZONINGAPPROVAL. A APPROVAL TO ISSUE: PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION T OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractors' State License Law for the reason(s) indicated below by the checkmark(s) I have placed next to the applicable item(s) (Section 7031.5, Business and Professions Code: Any city or county that requires a permit to construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for the permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractors' State License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or that he or she is exempt from licensure and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a. civil penalty of not more than five hundred dollars ($500). 1201 N TUSTIN ❑ 1, as owner of the property, or my employees with wages as their sole compensation, will do L) all of or L portions of the work, and the structure is not intended or offered for sale (Section 7044, Business and Professions Code: The Contractors' State License Law does not apply to an owner of property who, through employees' or personal effort, builds or improves the property, provided that the improvements are not intended or offered for sale. If, however, the building or improvement is sold within one year of completion, the Owner -Builder will have the burden of proving that it was not built or im roved for the purpose of sale): 1, as owner of the property, am exclusively contracting with licensed Contractors to construct the project (Section 7044, Business and Professions Code: The Contractors' State License Law does not apply to an owner of property who builds or improves thereon, and who contracts for the projects with a licensed Contractor pursuant to the Contractors' State License Law)..: ❑ 1 am exempt from licensure under the Contractors' State License Law for the following reason: By my signature below I acknowledge that, except for my personal residence in which I must have resided for at least one year prior to completion of the improvements covered by this permit. I cannot legalh sell a structure that I have built as an owner -builder if it has not been constructed in its entirety by licensed contractors. I understand that a copy of the applicable law, Section 7044 of the Business and Professions Code, is available upon request when this application is submitted or at the following Web site:http://www.leginfo.ca.gov/calaw.htm]. Signature of Property Owner or Authorized Agent Date LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Secti7 00) f Di is' n 3 of the Business and Professi y- d c 'a'in full force and effect. License Class License No Da Contractor Signatu WORKERS' COMPENSATION DECLARATION NARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. hereby affirm under penalty of perjury one of the following declarations: and will maintain a certificate of consent to self -insure for workers' compensation, issued by the Director of Industrial Relations as provided for by Section 3700 of the Labor Code, for ice of the work for which this permit is issued. Policy No. and will maintain workers' compensation insurance, as required by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. My workers' compensa'l carrier and policy number are: Policy Number Date me of Agent Phone # DATE •' • • ° ° certify that, in the perfo nc) of the wo o hick this mit is issued, I shall not employ any person in any manner so as to become subject to the workers' compensation laws 0 Valifornia, and a(3re t, if I should becomes ject t e wo r ' compe n provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. �„_ %7 , ...... •..OP El I SUBMITTED ASBESTOS NOTIFICATION TO (/ PERMITCANCELLED nature of Annfl OEPA PERMITEXTENDED CLARATION RE~G G S ION LENDING AGENCY QMD POOLALARMS INSTALLED )reby affirm under alty of perjury that there is a construction lending agency for the performance of the work for which this permit is issued (Section 3097, Civil Code). ...... ' ider's Name Lender's Address my signature below,. I.certify to each of the following: , • •, •' ° I am the property owner or authorized to act on the property owner's a . .. . I have read this application and the information I hav rovided is rr I agree to comply with all applicable city and co y ' nce tate law sting to building construction. - j/ • ... ...goo c ° I authorize representatives of this city or cou tb r the e4dent' ' d ope tion purposes. - / P iI� LLL"' I Q v • • "' Date J nature of ProDertv Owner or Authorized Ace" Print Property Owner's or Authorized A ent's a ( ACTION DATE CLARATION OF COMPLIANCE WITH CODE OF FEDERAL REGULATIONS PART 61 OF TITLE 40 AND AQMD RULE 1403 FOR OFFICE USE ONLY J PERMIT EXPIRED El I SUBMITTED ASBESTOS NOTIFICATION TO PERMITCANCELLED OEPA PERMITEXTENDED QMD POOLALARMS INSTALLED 7��1'�� ASBESTOS NOTIFICATION IS NOT APPLICABLE TO PROPOSED DEMOLITION. SIGNATURE: PERMITFINAL